{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:37:26Z","timestamp":1791596246787,"version":"4.3.4"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["1R01AI125738-01 \/ SUB 00001715"],"award-info":[{"award-number":["1R01AI125738-01 \/ SUB 00001715"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In our previous study of blood donors in the Argentinian Chaco Province, we documented bimodal distributions of anti-<jats:italic>Trypanosoma cruzi<\/jats:italic> antibody (Ab) levels, suggesting potential self-cure in donors with low-reactive samples. This study aimed to correlate \u201chigh\u201d and \u201clow\u201d Ab level groups, defined by a mathematical model, with parasitemia and electrocardiogram findings. Ab decline over time was also assessed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/ principal findings<\/jats:title>\n<jats:p>We invited <jats:italic>T. cruzi<\/jats:italic> Ab reactive blood donors to enroll in the study from October 2018 to November 2019 with a follow up visit two years later. Blood samples were tested for <jats:italic>T cruzi<\/jats:italic> Ab by: Chagatest ELISA Lisado and Chagatest ELISA Recombinante v.4.0 (Wiener Lab, Argentina); VITROS Immunodiagnostic Products Anti-T.cruzi (Chagas) (Ortho-Clinical Diagnostics Inc., UK), and Architect Chagas (Abbott Laboratories, Germany). Target capture polymerase chain reaction (PCR) was performed on lysed whole blood samples from enrollment visits and electrocardiograms on second visits.<\/jats:p>\n<jats:p>Four hundred fifty donors were recruited, but 68 were excluded due to negative results on all study Ab assays. Ab level distributions were bimodal and classified as \u201chigh\u201d or \u201clow\u201d at a calculated threshold for each of four assays. There were 160 donors with low and 179 with high Ab results on all assays. The remainder 43 were discordant reactive. Ninety-seven percentage of the PCR positive donors were among the concordant high Ab group. During the 2\u20134 year follow-up interval, relative Ab declines by three assays were significantly greater among those classified as low Ab and with negative PCR results.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/ significance<\/jats:title>\n<jats:p>Ab reactivity is associated with PCR-detectable parasitemia. Greater Ab declines were detected among donors with low and\/or discordant Ab reactivity and negative PCR results, suggesting spontaneous parasite clearance in these donors.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012724","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:53:33Z","timestamp":1748627613000},"page":"e0012724","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Bimodal distributions of anti-Trypanosoma cruzi antibody levels in blood donors are associated with parasite detection and antibody waning in peripheral blood"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5656-1144","authenticated-orcid":true,"given":"Mirta C.","family":"Remesar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester C.","family":"Sabino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis F.","family":"Buss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio D.","family":"Merlo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica G.","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e1n L.","family":"Humeres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor A.","family":"Pav\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Di Germanio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia Bakkour","family":"Coco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9a C.","family":"Oliveira-da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Martins Pinto Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio L.","family":"Ribeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Busch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana E.","family":"del Pozo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"issue":"12","key":"pntd.0012724.ref001","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1038\/s41569-024-01057-3","article-title":"Cardiac involvement in Chagas disease and African trypanosomiasis","volume":"21","author":"EC Sabino","year":"2024","journal-title":"Nat Rev Cardiol"},{"issue":"10115","key":"pntd.0012724.ref002","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S0140-6736(17)31612-4","article-title":"Chagas disease","volume":"391","author":"JA P\u00e9rez-Molina","year":"2018","journal-title":"Lancet"},{"issue":"1","key":"pntd.0012724.ref003","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1111\/vox.13164","article-title":"International survey of strategies to mitigate transfusion-transmitted Trypanosoma cruzi in non-endemic countries, 2016-2018","volume":"117","author":"LA Crowder","year":"2022","journal-title":"Vox Sang"},{"issue":"12","key":"pntd.0012724.ref004","doi-asserted-by":"crossref","first-page":"2628","DOI":"10.1111\/j.1537-2995.2010.02756.x","article-title":"Enhanced classification of Chagas serologic results and epidemiologic characteristics of seropositive donors at three large blood centers in Brazil","volume":"50","author":"EC Sabino","year":"2010","journal-title":"Transfusion"},{"key":"pntd.0012724.ref005","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1046\/j.1537-2995.1996.36111297091740.x","article-title":"Risk of exposure to Chagas\u2019 disease among seroreactive Brazilian blood donors","volume":"36","author":"NA Salles","year":"1996","journal-title":"Transfusion"},{"issue":"10","key":"pntd.0012724.ref006","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1111\/trf.13180","article-title":"Bimodal distribution of Trypanosoma cruzi antibody levels in blood donors from a highly endemic area of Argentina: what is the significance of low-reactive samples?","volume":"55","author":"M Remesar","year":"2015","journal-title":"Transfusion"},{"issue":"10422","key":"pntd.0012724.ref007","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0140-6736(23)01787-7","article-title":"Chagas disease","volume":"403","author":"AS de Sousa","year":"2024","journal-title":"Lancet"},{"key":"pntd.0012724.ref008","volume-title":"Pan American Health Organization. Guidelines for the Diagnosis and Treatment of Chagas Disease","year":"2019"},{"issue":"11","key":"pntd.0012724.ref009","doi-asserted-by":"crossref","first-page":"2352","DOI":"10.1111\/j.1537-2995.2009.02301.x","article-title":"Estimation of sensitivity and specificity of several Trypanosoma cruzi antibody assays in blood donors in Argentina","volume":"49","author":"MC Remesar","year":"2009","journal-title":"Transfusion"},{"issue":"1","key":"pntd.0012724.ref010","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1590\/S0037-86822003000100014","article-title":"New evidence of spontaneous cure in human Chagas\u2019 disease","volume":"36","author":"SS Francolino","year":"2003","journal-title":"Rev Soc Bras Med Trop"},{"issue":"5","key":"pntd.0012724.ref011","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1590\/S0037-86822008000500014","article-title":"Further evidence of spontaneous cure in human Chagas disease","volume":"41","author":"JCP Dias","year":"2008","journal-title":"Rev Soc Bras Med Trop"},{"issue":"6","key":"pntd.0012724.ref012","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1111\/j.1537-2995.2012.03902.x","article-title":"Antibody levels correlate with detection of Trypanosoma cruzi DNA by sensitive polymerase chain reaction assays in seropositive blood donors and possible resolution of infection over time","volume":"53","author":"EC Sabino","year":"2013","journal-title":"Transfusion"},{"issue":"6","key":"pntd.0012724.ref013","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1093\/trstmh\/trt029","article-title":"Clinical characteristics and outcome of 107 adult patients with chronic Chagas disease and parasitological cure criteria","volume":"107","author":"GL Bertocchi","year":"2013","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"10","key":"pntd.0012724.ref014","doi-asserted-by":"crossref","first-page":"724","DOI":"10.7326\/0003-4819-144-10-200605160-00006","article-title":"Long-term cardiac outcomes of treating chronic Chagas disease with benznidazole versus no treatment: a nonrandomized trial","volume":"144","author":"R Viotti","year":"2006","journal-title":"Ann Intern Med"},{"issue":"1","key":"pntd.0012724.ref015","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1590\/S0037-86821988000100003","article-title":"Does a spontaneous cure for Chagas\u2019 disease exist?","volume":"21","author":"R Zeled\u00f3n","year":"1988","journal-title":"Rev Soc Bras Med Trop"},{"issue":"9","key":"pntd.0012724.ref016","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1136\/heartjnl-2022-321754","article-title":"Electrocardiographic findings and prognostic values in patients hospitalised with COVID-19 in the World Heart Federation Global Study","volume":"109","author":"MM Pinto-Filho","year":"2023","journal-title":"Heart"},{"issue":"1","key":"pntd.0012724.ref017","article-title":"Electrocardiographic abnormalities in elderly Chagas disease patients: 10-year follow-up of the Bambui Cohort Study of Aging","volume":"3","author":"ALP Ribeiro","year":"2014","journal-title":"J Am Heart Assoc"},{"issue":"15","key":"pntd.0012724.ref018","doi-asserted-by":"crossref","first-page":"3292","DOI":"10.1017\/S095026881500059X","article-title":"Determination of cut-off cycle threshold values in routine RT-PCR assays to assist differential diagnosis of norovirus in children hospitalized for acute gastroenteritis","volume":"143","author":"NV Trang","year":"2015","journal-title":"Epidemiol Infect"},{"key":"pntd.0012724.ref019"},{"issue":"4","key":"pntd.0012724.ref020","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/S1473-3099(23)00629-1","article-title":"Efficacy of three benznidazole dosing strategies for adults living with chronic Chagas disease (MULTIBENZ): an international, randomised, double-blind, phase 2b trial","volume":"24","author":"P Bosch-Nicolau","year":"2024","journal-title":"Lancet Infect Dis"},{"issue":"19","key":"pntd.0012724.ref021","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1161\/CIRCULATIONAHA.121.055112","article-title":"Incidence and Predictors of Progression to Chagas Cardiomyopathy: Long-Term Follow-Up of Trypanosoma cruzi-Seropositive Individuals","volume":"144","author":"MCP Nunes","year":"2021","journal-title":"Circulation"},{"issue":"10","key":"pntd.0012724.ref022","article-title":"Declining antibody levels to Trypanosoma cruzi correlate with polymerase chain reaction positivity and electrocardiographic changes in a retrospective cohort of untreated Brazilian blood donors","volume":"14","author":"LF Buss","year":"2020","journal-title":"PLoS Negl Trop Dis"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0012724","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:53:39Z","timestamp":1748627619000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0012724"}},"subtitle":[],"editor":[{"given":"Bradford S","family":"McGwire","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":22,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0012724","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]}}}